Journal Legal and Administrative Studies, Year XX, No. 2 (25) – 2021 (preprint)

In this issue of Journal of Legal and Administrative Studies (JLAS) are included scientific articles which debate problems from legal sciences field: OPEN STATEHOOD AND CONSTITUTIONAL CHANGE; ACTIVITIES OF PRIVATE MILITARY AND SECURITY COMPANIES IN SOME AFRICAN STATES; RATIO DECIDENDI END THE SCIENCE OF LAW; INITIAL TREATIES - PRIMARY SOURCES OF EUROPEAN UNION LAW; LIMITING SENIORS' RIGHT TO VOTE; THE CONCEPT OF CIVIL SERVICE INTEGRITY; THE TRANSPORT OF PERSONS UNDER NATIONAL LAW, IN THE CONTEXT OF THE CORONAVIRUS PANDEMIC etc.The Journal of Legal and Administrative Studies was founded in 2002 and it is dedicated to the academic teachers and researchers, lawyers, magistrates, Ph.D. students and post-doctoral researchers into legal and administrative sciences and their auxiliary sciences, from Romania and from abroad. Subjects for submission include the following main areas, but are not limited to them: Public Law, Private Law, Protection of human rights and protection against discrimination, European Union law, Forensics and Criminology, Legal Sociology, History of law, juridical philosophy.The journal promotes the original researches that contributes to the knowledge progress and are motivated by the necessity of studying the theory and practice in the mentioned areas. Also, the journal aims to create a forum for disciplinary and interdisciplinary debates and to become a standard in the national and international juridical and administrative research.

Safety and efficacy of a dose-dense short-term therapy in patients with MYC-translocated aggressive lymphoma.

Patients with aggressive B-cell lymphoma and MYC rearrangement at fluorescence in situ hybridization exhibit poor outcome after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). In the last decade, 68 patients with Burkitt lymphoma ([BL] n = 46) or high-grade B-cell lymphoma ([HGBCL] single, double, or triple hit; n = 22) were treated with a dose-dense, short-term therapy termed "CARMEN regimen" at 5 Italian centers. Forty-six (68%) patients were HIV+. CARMEN included a 36-day induction with sequential, single weekly doses of cyclophosphamide, vincristine, rituximab, methotrexate, etoposide, and doxorubicin plus intrathecal chemotherapy, followed by high-dose-cytarabine-based consolidation. Patients who did not achieve complete remission (CR) after induction received BEAM (carmustina, etoposide, cytarabine, melfalan)-conditioned autologous stem cell transplantation (ASCT) after consolidation. Sixty-one (90%) patients completed induction, and 59 (87%) completed consolidation. Seventeen patients received ASCT. Grade 4 hematological toxicity was common but did not cause treatment discontinuation; grade 4 nonhematological toxicity was recorded in 11 (16%) patients, with grade 4 infections in 6 (9%). Six (9%) patients died of toxicity (sepsis in 4, COVID-19, acute respiratory distress syndrome). CR rate after the whole treatment was 73% (95% confidence interval [CI], 55% to 91%) for patients with HGBCL and 78% (95% CI, 66% to 90%) for patients with BL. At a median follow-up of 65 (interquartile range, 40-109) months, 48 patients remain event free, with a 5-year progression-free survival of 63% (95% CI, 58% to 68%) for HGBCL and 72% (95% CI, 71% to 73%) for BL, with a 5-year overall survival (OS) of 63% (95% CI, 58% to 68%) and 76% (95% CI, 75% to 77%), respectively. HIV seropositivity did not have a detrimental effect on outcome. This retrospective study shows that CARMEN is a safe and active regimen both in HIV-negative and -positive patients with MYC-rearranged lymphomas. Encouraging survival figures, attained with a single dose of doxorubicin and cyclophosphamide, deserve further investigation in HGBCL and other aggressive lymphomas.

The Impact of Covid-19 On Maternal Delivery Experiences and Breastfeeding Practices in China: A Cross-Sectional Study (preprint)

Background: The COVID-2019 pandemic has placed extensive pressure on health systems and posed a severe public health challenge worldwide. Lockdown measures implemented in many countries have delayed virus spread. However, a considerable number of people have faced unprecedented pressure, especially the pregnant and breast-feeding women, because face-to‐face professional support has been reduced during the lockdown in many countries. Objectives To compare the delivery and infant feeding experiences of women who delivered before (BL) versus during (DL) the Covid-19 pandemic in Beijing, China. Methods Women aged ≥ 18 years with an infant ≤ 18 months of age completed an anonymous survey. Information/links were shared online and via local clinics in Beijing. Logistic regression was performed to assess predictors of breastfeeding during the first 6-months. Results 2233 women provided data; BL 1241 (55.6%), DL 992 (44.4%). The 6-month mostly breastfeeding (MBF, mainly breastfeeding with few non-formula fluids added) rate was significantly higher in the DL mothers (71.6%), compared to the BL mothers (60.6%). MBF was predicted by delivery during the lockdown period (OR1.42, 95% confidence interval 1.06, 1.90), younger maternal age, discussing infant feeding in a feeding support group, and getting support from friends or relatives. Moreover, relative to those little affected by COVID, those who were much affected were less likely to MBF. Conclusion The COVID-19 pandemic and lockdown measures influenced mothers’ planned birth location and breastfeeding intention. However, breastfeeding practice was maintained during the pandemic. The reported breastfeeding rates were high and our results highlight the importance of feeding support as well as potential beneficial effects of increased mother-infant contact during the lockdown period which is relevant even under normal circumstances.

High-dose methotrexate-induced reversible grade 4 hyperbilirubinaemia and transaminitis in an adolescent with Burkitt Leukaemia.

Symptomatic drug-induced liver injury (DILI) is an uncommon problem. Direct DILI is dose-related, predictable with short latency (hour to days) and is generally associated with transient and reversible transaminitis without jaundice. Antimetabolites including methotrexate are a common cause for direct DILI. Hepatotoxicity associated with high-dose methotrexate (HD-MTX) is generally transient and includes reversible elevation of transaminase in up to 60% and associated hyperbilirubinaemia (≤grade 2) in 25% of courses and therefore is of no clinical significance. Severe grades of DILI with HD-MTX (grade ≥4) are extremely rare. We describe an adolescent with Burkitt leukaemia who had reversible grade 4 DILI including hyperbilirubinaemia postfirst course of HD-MTX. Rechallenge with two-third dose of HD-MTX in subsequent chemotherapeutic cycle did not cause recurrence of DILI.